Early postoperative growth in non-functioning pituitary adenomas; A tool to tailor safe follow-up
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ENDOCRINE METHODS AND TECHNIQUES
Early postoperative growth in non-functioning pituitary adenomas; A tool to tailor safe follow-up Kristin Astrid Øystese 1,2 Manuela Zucknick3 Olivera Casar-Borota4,5,6 Geir Ringstad2,7 Jens Bollerslev2,8 ●
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Received: 3 March 2017 / Accepted: 28 April 2017 © Springer Science+Business Media New York 2017
Abstract Purpose Non-functioning pituitary adenomas are common, and the treatment and follow-up of these patients represent a multidisciplinary challenge. First line treatment is transphenoidal surgery, with debulking or total removal of tumour. A substantial portion of the tumours relapse after surgery, and there is no consensus of how to follow these patients postoperatively. Our aim was to characterize the postoperative growth of non-functio-
Geir Ringstad and Jens Bollerslev shared last authorship. * Kristin Astrid Øystese [email protected] 1
Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital Rikshospitalet, P.b.4950 Nydalen, Oslo 0424, Norway
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Faculty of Medicine, University of Oslo, Oslo, Norway
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Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Department of Immunology, Genetics and Pathology, Uppsala University, Rudbeck Laboratory, Dag Hammarskjölds väg 20, Uppsala 751 85, Sweden
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Department of Clinical Pathology and Cytology, Uppsala University Hospital, Rudbeck Laboratory, Dag Hammarskjölds väg 20, Uppsala 751 85, Sweden
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Department of Pathology, Oslo University Hospital, Sognsvannsveien 20, Oslo 0372, Norway
ning pituitary adenomas and correlate it to clinical and paraclinical data. Methods We retrospectively registered 52 patients operated for non-functioning pituitary adenomas, with four or more consecutive MR-investigations not interrupted by secondary treatment. Adenoma volumes were estimated by the Cavalieri principle with summation of manually drawn areas multiplied by slice interval. Growth curves were modelled and tumour volume doubling time was calculated for 39 tumours with regrowth after surgery. Results A total of 13 tumours showed exponential growth, 10 linear growth and 16 logistic growth after surgery. The remaining 13 did not show regrowth of tumour. Seven of the exponential growing tumours underwent secondary surgery, compared to one and two of linear and logistic growing tumours (p = 0.03), respectively. Initial tumour volume doubling time was significantly lower in logistic growing tumours than in exponential growing tumours (p < 0.01). Men had tumours with lower tumour volume doubling time than women (p = 0.03). None of the tumours demonstrated signs of accelerated growth. Conclusion Residual tumours following surgery frequently grow. The logistic growing tumours had the fastest initial growth in our cohort. We found no indication of accelerated growth, whereby the tumour volume doubling time might be used to predict a “worst-case” scenario when planning follow-up of these patie
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